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At least 973 records · Page 54Linked to original sources

PubMed2006

Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Knee injury and Osteoarthritis Outcome Score (KOOS) in Asians with knee osteoarthritis in Singapore.

OBJECTIVE: To cross-culturally adapt and validate Singapore English and Chinese versions of the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients with knee osteoarthritis (OA) in Singapore. METHODS: Singapore English and Chinese versions were cross-culturally adapted from the source English KOOS following standard guidelines (including cognitive debriefing). Patients were asked to complete identical questionnaires containing the KOOS, Short Form 36 Health Survey, and EQ-5D twice within 6 days. Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients (ICC), dimensionality using item-to-domain correlations and convergent and divergent construct validity using 14 and 13 a priori hypotheses, respectively. RESULTS: Singapore English and Chinese KOOS versions were well accepted by patients in pilot testing and were therefore administered to a consecutive sample of 127 English and 131 Chinese-speaking Singaporeans with knee OA. Cronbach's alpha exceeded 0.7 for all domains except for Chinese pain and symptoms domains. ICC exceeded 0.7 for all domains except for English sport and recreation and Chinese knee-related QoL domains. Hypothesized item-to-domain correlations (Spearman's rho>or=0.4) were observed for 38 items in English and 29 in Chinese versions. Convergent construct validity was supported by the presence of hypothesized moderate/strong correlations (rho=0.37-0.65) for 13 and 11 a priori hypotheses in the English and Chinese KOOS, respectively. Divergent construct validity was supported by the presence of weak correlations (rho=0.02-0.34) for 12 and 11 a priori hypotheses in the English and Chinese KOOS, respectively. CONCLUSION: The Singapore English and Chinese KOOS were well accepted and demonstrated acceptable reliability and validity in Asian patients with knee OA in Singapore.

Aged↗

PubMed2026

Development and validation of a comprehensive prognostic model for 28-day ICU mortality in non-traumatic subarachnoid hemorrhage: an analysis based on the MIMIC-IV database.

BACKGROUND: Due to the complex pathophysiology of non-traumatic subarachnoid hemorrhage (SAH), accurate risk prediction remains a challenge. Our aim is to develop and validate a comprehensive prognostic model that integrates demographic characteristics, vital signs, laboratory parameters, and more, to provide clinical decision-making support in real-world practice. METHODS: We conducted a retrospective cohort study of 785 Non-traumatic subarachnoid hemorrhage patients. The cohort was randomly divided into a training set (n = 549) and a validation set (n = 236). Feature selection was performed using LASSO regression, followed by backward stepwise Cox regression for optimization. A nomogram was constructed based on independent predictive factors, and model performance was assessed using discrimination, calibration, and decision curve analysis. To prevent immortal-time bias, all predictors were anchored to a fixed early (first-24-hour) measurement window, treatment variables were modelled as binary indicators rather than cumulative exposures, and a five-model sensitivity analysis with baseline-severity adjustment was performed. RESULTS: The development of our model followed a systematic approach: first, 15 potential predictive factors were selected via LASSO regression, which were then refined to 12 independent predictors using backward stepwise Cox regression. The final predictive factors included: Ventilation, AHT, Nimodipine 60 mg, Age, SAPS.II, Input amount, Calcium total, Platelet count, White blood cells, Anion gap, pH, and Chloride. The integrated model demonstrated excellent predictive ability for 7-day, 14-day, and 21-day mortality in both the training set (AUC: 0.972, 0.934, 0.898) and the validation set (AUC: 0.968, 0.948, 0.911). Calibration curves and decision curve analysis confirmed the model's reliability and clinical utility across different time points. We constructed a nomogram for individualized risk prediction. Univariate Kaplan-Meier survival analysis demonstrated significant stratification of survival outcomes by each predictor, while restricted cubic spline analysis revealed non-linear relationships between continuous variables and mortality risk. Random survival forest analysis identified the top three predictive factors (Nimodipine 60 mg, Ventilation, AHT) and compared them with our full 12-variable model, confirming superior performance of the integrated model at all time points. At the 28-day primary endpoint, the model achieved a time-dependent AUC of 0.898 (training) and 0.904 (validation); after restricting predictors to the early baseline window, the leakage-controlled model retained good discrimination (validation C-index 0.803). CONCLUSIONS: Our ICU 28-day mortality prognosis model demonstrated robust performance in predicting ICU 28-day mortality in non-traumatic subarachnoid hemorrhage. The model, through the nomogram, provides individualized risk assessment, aiding clinical decision-making and patient stratification.

Humans↗

PubMed2004

Validation study of the Chinese version of the Brief Fatigue Inventory (BFI-C).

A cross-sectional study was conducted among 249 Chinese cancer patients with multiple diagnoses to validate a Chinese version of the Brief Fatigue Inventory (BFI-C). Cronbach's coefficient alpha was 0.92 for fatigue severity items and 0.90 for fatigue interference items. Construct validity was explored by principal factor analysis and suggested a two-factor solution: fatigue severity and fatigue interference. Internal consistency reliability was excellent. Convergent validity was examined by correlating the BFI-C with 2 subscales and 2 component scores of the MOS 36-Item Short-Form Health Survey (coefficients ranged between -0.44 and -0.71, P<0.001). Known-group validity was examined by comparing fatigue severity in patients having different scores on the Eastern Cooperative Oncology Group Performance Status Scale. Approximately 60% of patients experienced moderate to severe fatigue (4 or greater on the 0-10 scale of the BFI-C "fatigue worst" item). The BFI-C is a valid, reliable instrument to measure the severity and impact of cancer-related fatigue among Chinese patients.

Adult↗

PubMed2004

Validation of a symptom measure suitable for use among palliative care patients in the community: CAMPAS-R.

The purpose of the study was to investigate psychometric properties of CAMPAS-R, an instrument for prospectively monitoring patients' symptoms and needs during palliative care at home. CAMPAS-R was piloted for face and content validity and then administered alongside criterion measures to a home care sample. Cronbach's alpha was used to test internal consistency and criterion-related validity was tested by non-parametric correlation with Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS) and EORTC QLQ-C30. Predictive validity was assessed by relating CAMPAS-R scores to survival. One hundred and nine patients were recruited to the study. Good reliability and high correlations between CAMPAS-R and criterion measures were found. Predictive validity was demonstrated by significant differences in symptom scores between groups differing in length of survival. CAMPAS-R is acceptable to patients, families and primary care professionals and is a valid, reliable instrument, which has the benefit of being easy to score.

Adult↗

PubMed2005

Validation in pharmaceutical analysis. Part II: Central importance of precision to establish acceptance criteria and for verifying and improving the quality of analytical data.

Validation of analytical procedures is a vital aspect not just for regulatory purposes, but also for their efficient and reliable long-term application. In order to address the performance of the analytical procedure adequately, the analyst is responsible to identify the relevant parameters, to design the experimental validation studies accordingly and to define appropriate acceptance criteria. Establishing an acceptable analytical variability for the given application is of central importance as many other acceptance criteria can be derived from such a precision. Acceptable precision ranges for types of control tests and/or analytes can be obtained from validation, but also related activities such as transfer, control charts, or extracted from routine applications such as batch release or stability studies (data mining). Apart from compiling a database for general benchmarking, during such an information-building process, the reliability of the analytical variability of the specific procedure is more and more increased. This is important as a reliable target variability facilitates to detect or investigate atypical or out-of specification behaviour of analytical data in a routine application, thus improving the data quality and reliability. According to the life-cycle concept of validation, measures should be taken to maintain and control the validated status of analytical procedures during long-term routine application, such as monitoring relevant performance parameters (system suitability tests), control charts, etc. If the analytical system is demonstrated to be stable, i.e. under statistical control, a major variability contribution in LC originating from the standard preparation and analysis can be reduced. A concept of quantification by pre-determined calibration parameters instead of the classical approach of simultaneous calibration is described.

Chemistry, Pharmaceutical↗

PubMed2004

A validated HPLC method for determining residues of a dual active ingredient anti-malarial drug on manufacturing equipment surfaces.

Analytical method validation, determining the recovery rate from the equipment surface and the stability of a potential contaminant are important steps of a cleaning validation process. A rapid, sensitive and reproducible reversed-phase high-performance liquid chromatographic method was developed for the determination of pyrimethamine (PYR) and sulfadoxine (SUL) in cleaning validation swab samples. The active compounds can be selectively quantified in a sample matrix containing detergent and swab material as low as 0.12 microg/ml. The swabbing procedure used on stainless steel coupons was validated and the stability of PYR and SUL in the swab samples was assessed. The calculated limit of contamination values for PYR (4.99 microg/cm2) and SUL (19.14 microg/cm2) were not exceeded during four consecutive equipment cleaning trials. This confirms that the desired level of cleanliness is achieved with the current cleaning procedures, which are consequently validated.

Antimalarials↗

PubMed2007

The urgency perception score: validation and test-retest.

PURPOSE: We validate a grading system for urinary urgency. MATERIALS AND METHODS: A total of 225 subjects participated in a validation study of a fixed format question that examined the reasons why an individual usually voids. The response comprised 5 graded categories. The written questionnaire was completed by the subject twice in 3 to 14 days, during which there was no change in symptoms. Subjects included asymptomatic normal volunteers and consecutive patients with lower urinary tract symptoms without urinary urgency and those with overactive bladder with or without other lower urinary tract symptoms. Content validity was established by an expert panel. Discriminant validity was assessed by examining the frequency of responses in the various categories across the 3 groups (chi-square test) and by comparing average scores in each of the 3 groups using 1-way ANOVA, followed by LSD post hoc tests. Test-retest reliability was assessed using the intraclass correlation coefficient and kappa coefficient. RESULTS: A total of 83 normal subjects, 62 patients with lower urinary tract symptoms and 80 patients with overactive bladder were included in the study. Median age was 71 years (range 21 to 97). For test-retest reliability the intraclass correlation coefficient (0.86) and kappa coefficient (0.68) indicated a good level of agreement (p <0.001). The overactive bladder group achieved a significantly higher score than the normal and lower urinary tract symptoms groups (mean +/- SD 2.5 +/- 0.99 vs 1.6 +/- 0.93 and 1.8 +/- 0.93, respectively, each p <0.001). CONCLUSIONS: The urgency perception score appears to be a valid and reliable means of grading urinary urgency. We believe that this method of grading urgency will prove to be more clinically useful than the simple yes/no characterization of urgency as a sudden compelling desire to void and it will be a useful item for questionnaires and diary keeping.

Adult↗

PubMed2007

Development and external validation of an extended repeat biopsy nomogram.

PURPOSE: We hypothesized that the outcome of repeat biopsy could be accurately predicted. We tested this hypothesis in a contemporary cohort from 3 centers. MATERIALS AND METHODS: The principal cohort of 1,082 men from Hamburg, Germany was used for nomogram development as well as for internal 200 bootstrap validation in 721 and external validation in 361. Two additional external validation cohorts, including 87 men from Milan, Italy and 142 from Seattle, Washington, were also used. Predictors of prostate cancer on repeat biopsy were patient age, digital rectal examination, prostate specific antigen, percent free prostate specific antigen, number of previous negative biopsy sessions and sampling density. Multivariate logistic regression models were used to develop the nomograms. RESULTS: The mean number of previous negative biopsies was 1.5 (range 1 to 6) and the mean number of cores at final repeat biopsy was 11.1 (range 10 to 24). Of the men 370 (30.2%) had prostate cancer. On multivariate analyses all predictors were statistically significant (p < or =0.028). After internal validation the nomogram was 76% accurate. External validation showed 74% (Hamburg), 78% (Milan) and 68% (Seattle) accuracy. CONCLUSIONS: Relative to the previous nomograms (10 predictors or 71% accuracy) our tool relies on fewer variables (6) and shows superior accuracy in European men. Accuracy in American men is substantially lower. Racial, clinical and biochemical differences may explain the observed discrepancy in predictive accuracy.

Adult↗

PubMed2005

Identification of gene markers based on well validated and subcategorized stressed animals for potential clinical applications in PTSD.

Post-traumatic stress disorder (PTSD) is a complex mental disorder that can develop in response to traumatic experiences. The molecular mechanisms underlying the pathology of PTSD are poorly understood, and this lack of knowledge hampers our ability to find superior therapeutic approaches to the treatment of this disorder. There are two main reasons for our lack of study in this area: here is no sufficiently validated animal model and lack of large-scale studies for the search of underlying molecular mechanisms. Thus, to promote research on PTSD (especially its molecular mechanisms) and to set molecular basis for searching novel medications of this disorder, large-scale, genome-wide interrogation of a significant amount of genes based upon a well validated animal model is demanded. We hypothesize that a significant number of genes are involved in PTSD. It is only with a large number of these genes identified in specific samples of PTSD-related population, and then it is possible for a sufficient understanding of the pathology at the molecular level of a PTSD, as well as for enhancing the PTSD's therapeutic and preventative strategies. Two prerequisites are needed for testing this hypothesis: (1) relative pure samples from a well validated animal model; and (2) genome-wide screening of PTSD molecular targets. For the animal model, we suggest to use the predator-exposure paradigm, in which rats are exposed to a predator, this model has previously been evaluated behaviorally well emulated the clinical symptoms of PTSD. For a better stringency, three criteria can be used to further validate this animal model: analogous (similarity of behavior), predictive (predictability of drug response) and biological mechanism (e.g., electrophysiological and pathological change in amygdala). For large-scale molecular target screening, the new microarray technology, which can profile expression of tens of thousands genes simultaneously, is the method of choice. The validity and practicability of this hypothesis and the strategy for its testing have been supported by our preliminary laboratory data.

Animals↗

PubMed2005

Development and validation of a questionnaire to test knowledge and practices of dietitians regarding dietary supplements.

OBJECTIVE: We developed a questionnaire to evaluate dietitians' knowledge and practices about the use of dietary supplements in light of new draft regulations in South Africa that will allow dietitians to prescribe supplements for the management of nutrition-related diseases. METHODS: A cross-sectional validation study was carried out in two phases: 1) questionnaire planning and development and 2) determination of reliability (internal consistency). The study sample comprised 48 nurses, 105 dietetic interns, and 367 registered dietitians. An expert academic group comprising nine dietitians with research and teaching experience rated the academic relevance and importance of knowledge questions in an item pool of 355 questions to ensure face and content validity. Criterion validity was measured by testing the knowledge questions (KQs) on 48 nurses and 105 dietetic interns. Thereafter questions were deleted based on their difficulty, discrimination, and Cronbach's alpha values. The final questionnaire, which at this point included a test of 50 KQs, was mailed to registered dietitians (n = 1450) in South Africa to determine internal consistency of the final KQs. RESULTS: Criterion validity of the KQs was indicated by a significant difference (P = 0.000) in the mean test scores between nurses (36.9, 95% confidence interval 24.2 to 39.6) and dietetic interns (40.2, 95% confidence interval 38.8 to 41.7). Item discrimination was attained by the deletion of NQs having a minimum correlation of 0.20 with overall test score. Further, item difficulty was controlled for by removal of questions correctly answered by more than 80% (too easy) or fewer than 20% (too difficult). Internal consistency of the KQs, after completion by 367 dietitians, was 0.87 (Cronbach's alpha). The mean knowledge score of dietitians ranged from 56.5% to 62.5%, with the oldest group (> or =40 y) having the highest score (P = 0.018). Thirty-eight percent of dietitians recommended dietary supplements at least 3 times a week; 51% consumed dietary supplements themselves; and 17% sold them to clients. CONCLUSIONS: A valid and reliable questionnaire that tests knowledge and practices of dietary supplements was developed for dietitians. This tool can be used by academic institutions to evaluate the knowledge and practices of final-year students. It can also be used on a representative sample of dietitians in South Africa and possibly elsewhere within the profession.

Adult↗

PubMed2006

Development and face and content validity of an eye surgical skills assessment test for ophthalmology residents.

PURPOSE: The Accreditation Council for Graduate Medical Education has called for the development of new tools for teaching and assessment in core residency competencies. Aims of this study were to respond to this mandate by developing an objective method of evaluating the surgical skills of ophthalmology residents in a microsurgery laboratory environment that could become a part of the ophthalmic surgical curriculum and competency determination, and to evaluate the face and content validity of this assessment by surveying experts in the field. DESIGN: Survey. PARTICIPANTS: Twenty-two content experts (residency program directors and faculty members involved with resident surgical training). METHODS: We have developed a 3-station (skin suturing, muscle recession, phacoemulsification/wound construction and suturing technique) wet laboratory surgical skills obstacle course for ophthalmology residents. Each station includes instructions to the resident for completing the task as well as assessment forms, a station-specific checklist, and a global rating scale of performance, for expert surgeons to complete while reviewing the resident's videotaped performance. To establish face and content validity, content experts were sent a detailed explanation of the assessment along with a survey to facilitate constructive feedback. MAIN OUTCOME MEASURES: Survey responses. RESULTS: Experts felt that the Eye Surgical Skills Assessment Test (ESSAT) is a useful and representative tool for assessing surgical skills of residents. Suggestions were incorporated, thus establishing the face and content validity. CONCLUSIONS: The ESSAT has face and content validity. This tool will be useful for assessing residents' surgical skills in a laboratory environment and the impact of various teaching methods on performance. Further studies to establish the interrater reliability and construct validity of the ESSAT are underway.

Animals↗

PubMed2005

The significant other version of the Pain Catastrophizing Scale (PCS-S): preliminary validation.

Researchers have hypothesized that pain catastrophizing has a social function. Although work has focused on the catastrophizing of individuals with chronic pain (ICPs), little is known about the pain catastrophizing of their significant others. The purpose of this study was to test the validity of a revised version of the original PCS [Sullivan MJL, Bishop S, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess 1995; 7: 432-524.] in which individuals were instructed to report on their own catastrophizing about their significant other's pain. In Study 1, a confirmatory factor analysis was conducted to determine the factor structure of the PCS-Significant Other (PCS-S) in a diverse sample of university undergraduates (n=264). An oblique second-order 3-factor model with two cross-loadings provided the best fit and this model was invariant across gender and racial groups. This factor structure was cross-validated in Study 2 with a second sample of university undergraduates (n=213). Results indicated that the 3-factor structure with two cross-loadings was a viable model of significant others' pain catastrophizing across gender and racial groups. In Study 3, this factor structure was replicated and the content validity of the PCS-S was examined in a sample of adult ICPs and their spouses (n=111). Spouse catastrophizing was related to ICP pain severity and interference as well as both spouses' depressive symptoms. In addition, ICPs were at a greater risk for psychological distress when both spouses had higher levels of catastrophizing. The PCS-S has the potential to be a useful and valid measure of pain catastrophizing in the significant others of ICPs.

Adult↗

PubMed2006

Development and first validation of the shared decision-making questionnaire (SDM-Q).

OBJECTIVE: Due to a lack of valid German instruments measuring shared decision-making (SDM), a theory-driven questionnaire (SDM-Q) to measure the process of SDM was developed and validated. METHODS: As a theoretical basis steps of the SDM process were defined in an expert panel. Item formulation was then conducted according to the Delphi method. For the first validation on a mixed sample Rasch analysis was used to eliminate items not fitting the construct thus receiving a unidimensional scale. RESULTS: After eliminating 4 items the remaining 11 form a unidimensional scale with an acceptable reliability for person measures (0.77) and very good reliability for item difficulties (0.95). Analysis of subgroups revealed a different use of items in different conditions. Furthermore the scale showed high ceiling effects. CONCLUSION: A new theory-driven instrument to measure the process of SDM has been developed and validated by use of a rigorous method revealing first promising results. Yet the ceiling effects require the addition of more discriminating items, and the different use of items in different conditions demands an in depth analysis. PRACTICE IMPLICATIONS: While the concept of SDM is constantly receiving more attention in medical practice, its valid and reliable measurement remains challenging.

Decision Making↗

PubMed2006

Assessment of neonatal resuscitation skills: a reliable and valid scoring system.

OBJECTIVE: To study the reliability and validity of a scoring instrument for the assessment of neonatal resuscitation skills in a training setting. METHODS: Fourteen paediatric residents performed a neonatal resuscitation on a manikin, while being recorded with a video camera. The videotapes were analysed using an existing scoring instrument with an established face and content validity, adjusted for use in a training setting. Intra- and inter-rater reliability were assessed by comparing the ratings of the videotapes of three raters, one of who rated the videotapes twice. Intra-class coefficients (ICC) were calculated for the sum score, percentages of agreement and kappa coefficients for the individual items. To study construct validity, the performance of a second resuscitation of by residents was assessed after they had received feedback on their first performance. RESULTS: The ICC were 0.95 and 0.77 for intra- and inter-rater reliability, respectively. The median percentage of intra-rater agreement was 100%; inter-rater agreement 78.6-84.0%. The median kappa was 0.85 for intra-rater reliability, and 0.42-0.59 for inter-rater reliability. Residents showed a 10% improvement (95% confidence interval -4; 23%) on performance of a second resuscitation, which supports the instrument's construct validity. CONCLUSION: A useful and valid instrument with good intra-rater and reasonable inter-rater reliability is now available for the assessment of neonatal resuscitation skills in a training setting. Its reliability can be improved by using a more advanced manikin and by training of the raters.

Cardiopulmonary Resuscitation↗

PubMed2005

OECD validation of the Hershberger assay in Japan: Phase 3. Blind study using coded chemicals.

The Organization for Economic Co-operation and Development (OECD) has initiated the development of new guidelines for the screening and testing of potential endocrine disrupters. The Hershberger assay is one of the assays selected for validation based on the need for in vivo screening to detect androgen agonists or antagonists by measuring the response of five sex accessory organs and tissues of castrated juvenile male rats: the ventral prostate, the seminal vesicles with coagulating glands, the levator ani and bulbocavernosus muscle complex (LABC), Cowper's glands, and the glans penis. The Phase 1 feasibility demonstration stage of the Hershberger validation program has been successfully completed with a single androgen agonist and a single antagonist as reference substances. The Phase 2 validation study was performed, employing a range of additional androgen agonists and antagonists. Recently, the Phase 3 validation study was conducted and performed in several International laboratories. Three Japanese laboratories have contributed to the blind study using coded materials of Phase 3 validation. Four coded test substances in the agonistic version and seven substances in the antagonistic version were orally administered by gavage for 10 consecutive days, respectively. In the antagonist version of the assay, 0.2mg/kg/day of testosterone propionate (TP) was coadministered by subcutaneous injection. All five accessory sex reproductive organs and tissues consistently responded with statistically significant changes in weight within a narrow window in both versions. Therefore, the Japanese studies support the Hershberger assay as a reliable and reproducible screening assay for the detection of androgen agonistic and antagonistic effects.

Androgen Antagonists↗

PubMed2001

Reliability and validity of the Child and Adolescent Trial for Cardiovascular Health (CATCH) Food Checklist: a self-report instrument to measure fat and sodium intake by middle school students.

OBJECTIVE: To develop a scoring algorithm and evaluate the reliability and validity of scores from the Child and Adolescent Trial for Cardiovascular Health (CATCH) Food Checklist (CFC) as measures of total fat, saturated fat, and sodium intake in middle school students. DESIGN: Randomized, controlled trial in which participants were assigned to 1 of 3 study protocols that varied the order of CFC and 24-hour dietary recall administration. Criterion outcomes were percent energy from total fat, percent energy from saturated fat, and sodium intake in milligrams. SUBJECTS/SETTING: A multiethnic sample (33% ethnic and racial minorities) of 365 seventh-grade students from 8 schools in 4 states. STATISTICAL ANALYSES: Multivariable regression models were used to calibrate the effects of individual food checklist items; bootstrap estimates were used for cross-validation; and kappa statistics, Pearson correlations, t tests, and effect sizes were employed to assess reliability and validity. RESULTS: The median same-day test-retest reliability kappa for the 40 individual CFC food items was 0.85. With respect to item validity, the median kappa statistic comparing student choices to those identified by staff dietitians was 0.54. Test-retest reliability coefficients ranged from 0.84 to 0.89 for CFC total nutrient scores. Correlations between CFC scores and 24-hour recall values were 0.36 for total fat, 0.36 for saturated fat, and 0.34 for sodium; CFC scores were consistent with hypothesized gender differences in nutrient intake. APPLICATIONS/CONCLUSIONS: The CFC is a reliable and valid tool for measuring fat, saturated fat, and sodium intake in middle school students. Its brevity and ease of administration make the CFC a cost-effective way to measure middle school students' previous day's intake of selected nutrients in school surveys and intervention studies.

Adolescent↗

PubMed2001

Development and validation of a screening tool to identify eating disorders in female athletes.

OBJECTIVE: To develop and validate a screening tool to identify eating pathology in women athletes. DESIGN: Three cross-sectional subject groups were established: college women athletes diagnosed with eating disorders; college women athletes without eating pathology; college women who did not participate in athletics but were diagnosed with an eating disorder. The Female Athlete Screening Tool (FAST), and 3 valid psychometric measures were administered to subjects in all groups. Internal reliability, discriminant and concurrent validity were established. SUBJECTS/SETTINGS: Women college students between the ages of 18 and 23 years (n=41) from the University of Connecticut and St Joseph College were recruited. The athletes were screened for eating disorders by a sports medicine team. STATISTICAL ANALYSIS: Cronbach's alpha, one-way analysis of variance, and correlation analyses. RESULTS: Reliability analysis indicated a high internal consistency of the FAST (Cronbach's alpha = 0.87). Athletes with eating disorders scored significantly higher on the FAST as compared with athletes without eating pathology and nonathletes with eating disorders (P<.001), which demonstrated discriminant validity. Correlation analyses showed that the FAST was strongly correlated to the Eating Disorder Examination-Questionnaire (0.60, P<.05) and Eating Disorder Inventory (0.89, P<.001). APPLICATIONS/CONCLUSIONS: Early detection of eating disorders can help prevent the onset or severity of a clinical eating disorder. By using the screening tool that has been validated for use in women athletes, dietetic professionals can quickly identify those athletes who need assistance with their aberrant eating habits.

Adolescent↗

PubMed2001

Development and validation of a clinical prediction rule for major adverse outcomes in coronary bypass grafting.

In this study, we develop and internally validate a clinical prediction rule for in-hospital major adverse outcomes, defined as death, renal failure, reinfarction, cardiac arrest, cerebrovascular accident, or coma, in patients who underwent coronary artery bypass grafting (CABG). All adult patients (n = 9,498) who underwent a CABG and no other concomitant surgery at 12 academic medical centers from August 1993 to October 1995 were included in the study. We assessed in-hospital major adverse outcomes and their predictors using information on admission, coronary angiography, and postoperative hospital course. Predictor variables were limited to information available before the procedure, and outcome variables were represented only by events that occurred postoperatively. We developed and internally validated a clinical prediction rule for any major adverse outcome after CABG. The rule's ability to discriminate outcomes and its calibration were assessed using receiver-operating characteristic analysis and the Hosmer-Lemeshow goodness-of-fit statistic, respectively. A major adverse outcome occurred in 6.5% of patients in the derivation set and 7.2% in the validation set. Death occurred in 2.5% of patients in the derivation set and 2.2% in the validation set. Sixteen variables were independently correlated with major adverse outcomes, with the risk score value attributed to each risk factor ranging from 2 to 12 points. The rule stratified patients into 6 levels of risk based on the total risk score. The spread in probability between the lowest and highest risk groups of having a major adverse outcome was 1.7% to 32.3% in the derivation set and 2.2% to 22.3% in the validation set. The prediction model performed well in both outcome discrimination and calibration. Thus, this clinical prediction rule allows accurate stratification of potential CABG candidates before surgery according to the risk of experiencing a major adverse outcome postoperatively.

Aged↗